title: Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance.
abstract: OBJECTIVE
  To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
  
  
  METHODS
  Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
  
  
  RESULTS
  Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA < 100 IU/mL) OR = 3 (95%CI: 2.6-4.2, P = 0.01) and duration of HBsAg seropositivity (> 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
  
  
  CONCLUSIONS
  We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
authors.affiliation: Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
authors.forename: Mahmud
authors.initials: M
authors.lastname: Mahamid
authors.forename: William
authors.initials: W
authors.lastname: Nseir
authors.forename: Omar
authors.initials: O
authors.lastname: Abu Elhija
authors.forename: Shimon
authors.initials: S
authors.lastname: Shteingart
authors.forename: Ammad
authors.initials: A
authors.lastname: Mahamid
authors.forename: Mosab
authors.initials: M
authors.lastname: Smamra
authors.forename: Benjamin
authors.initials: B
authors.lastname: Koslowsky
keywords: Hepatitis B; Immune disease; Seroclearance; Viral load; Vitamin D